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Pennsylvania rates for HCPCS 25628

Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $4,786.30 / $8,709.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $10,000.00 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$123.03 / $123.03 / $123.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $14,125.38 / $23,988.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $4,168.69 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,479.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $467.74 / $676.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $5,495.41 / $22,387.21